PB1960: SARS-COV-2 OMICRON VARIANT INFECTION AND COVID-19 IN PERSONS WITH CHRONIC MYELOID LEUKAEMIA IN CHINA
Authors: Fang Cheng, Weiming LI
Journal: HemaSphere (2023)

Topic: 7. Chronic myeloid leukemia - Biology & Translational Research Background: Under the new COVID-19 response strategies in China during December 2022, since then, Omicron infections have spread rapidly in all the major cities of China. Aims: We studied incidence and features of the recent SARS-CoV-2 Omicron variant epidemic in 1121 persons with chronic myeloid leukaemia (CML) in Hubei and Henan provinces in China using a detailed questionnaire. Methods: Patients with CML receiving TKI therapies from the Hubei and Henan provinces were recruited for this survey between November 15, 2022, to January 31, 2023. Subjects with CML or their guardians (if patients were not able to participate) were requested to complete the questionnaire (Supplementary information). The questionnaire included 30 questions assessing patient demographics, education, co-morbidities, Omicron exposure history, CML-related data including diagnosis, symptoms, therapies, and treatment response and outcomes. Any missing or unclear data items were completed or clarified through direct communication with the patients, their guardians and/or health-care providers. The impact of Omicron infection on the management of CML was also documented. This study was approved by the Institutional Ethics Committee of the Tongji Medical College, Huazhong University of Science and Technology (Wuhan, China) (Approval No. [2023] 0065) and the requirement for written informed consent was waived. Results: 1103 (98.4%) were in chronic phase, 10 (0.9%) in accelerated phase and 8 (0.7%) in acute phase. 834 (74%) were infected, a lower than the official infection rates of > 80% in Hubei province and 89% in Henan province. 792 people (70%) were diagnosed as coronavirus infectious disease-2019 (COVID-19). The most common symptoms of persons with COVID-19 were fever (91%), cough (90%) and fatigue (82%). 4% of SARS-Co-2-infected persons were asymptomatic. Most people quarantined at home and self-medicated. 22 subjects were hospitalized including 5 with mild, 14 with moderate and 3 with severe disease as described by the World Health Organization (WHO). 5 received respiratory assistance and 3 were admitted to the intensive care unit (ICU). 3 subjects interrupted tyrosine kinase-inhibitor (TKI) therapy during hospitalization, and 1 subject in accelerated phase died. Co-variates associated with increased risk of COVID-19 included older age, 3rd-line TKI-therapy, ≥ 1 co-morbidity, not in chronic phase when they infected and no major molecular response (MMR) to TKI-therapy. Compared with second- or third- generation TKIS therapy, patients received imatinib treatment more prone to COVID-19. Furthermore, the risk of COVID-19 was higher in CML patients who achieved treatment-free remission. The hospitalized CML patients with COVID-19 were older, with ≥1 comorbidities, with accelerated or blast phase, and without MMR at the time of COVID-19 diagnosis. Summary/Conclusion: In conclusion, Most of the COVID-19 cases are mild in CML persons and can be relieved under self-quarantine at home. High-risk CML persons (such as older, with ≥1 comorbidities, with accelerated or blast phase CML, and without MMR at the time of COVID-19 diagnosis) may benefit from increased surveillance of COVID-19 infection, protective isolation and timely medical treatment. Keywords: Chronic myeloid leukemia